<?php
/**
 * Created by PhpStorm.
 * User: CYJiao
 * Date: 6/7/15
 * Time: 22:05
 */

?>

<div class="easyui-layout" data-options="fit:true">
    <!--<div data-options="region:'north'" style="height:62px;"> </div>
    <div data-options="region:'south'" style="height:20px;"></div>
    -->
    <div data-options="region:'west'" style="width:150px;">
    	<div style="margin:20px 20px">
			<a href="#" class="easyui-linkbutton c1" style="width:120px;margin:10px 2px">个人资料</a>
			<a href="#" class="easyui-linkbutton" style="width:120px;margin:10px 2px">个人资料</a>
			<a href="#" class="easyui-linkbutton" style="width:120px;margin:10px 2px">个人资料</a>
			<a href="#" class="easyui-linkbutton" style="width:120px;margin:10px 2px">个人资料</a>
			<a href="#" class="easyui-linkbutton" style="width:120px;margin:10px 2px">个人资料</a>
		</div>
    	
    </div>
    <div data-options="region:'center'">
    	        <div class="easyui-panel" data-options="border:true,title:'个人资料'" style="width:100%;padding:5px;background:#fafafa;margin-bottom: 10px;">
            <div class="table-patient">
                <table style="width:100%;">
                    <tbody>
                    <tr>
                        <th align="right">真实姓名：</th>
                        <td><input class="easyui-textbox" name="phone" value=""/></td>

                        <th align="right">电话：</th>
                       
                            
                        
                            <td><input class="easyui-textbox" name="phone" value=""/></td>
                       
                    </tr>
                    <tr>
                        <th align="right">生日：</th>
                        <td><input class="easyui-datebox" name="dob" value=""/></td>
                        <th align="right">年龄：</th>
                        
                        <td></td>
                        <th align="right">职业：</th>
                        <td><input class="easyui-textbox" style="" name="occupation" value=""></td>
                    </tr>
                    <tr>
                        <th align="right">住址：</th>
                        <td colspan="5"><input class="easyui-textbox" style="width:50%" name="location" value=""></td>
                    </tr>
                    <tr>
                        <th align="right">体重：</th>
                        <td><input class="easyui-textbox" style="" name="weight" value="">&nbsp;kg</td>
                        <th align="right">身高：</th>
                        <td><input class="easyui-textbox" style="" name="stature" value="">&nbsp;cm</td>
                        <th align="right">民族：</th>
                        <td><input class="easyui-textbox" style="" name="blood_type" value=""></td>
                    </tr>
                    <tr>
                        <th align="right">饮酒：</th>
                        <td>
                            <select class="" name="alcohol">
                                <option value="1">无</option>
                                <option value="2">很少</option>
                                <option value="3">有时</option>
                                <option value="4">经常</option>
                                <option value="5">总是</option>
                            </select>
                        </td>
                        <th align="right">吸烟：</th>
                        <td><input class="easyui-textbox" style="width:50px;" name="smoke" value=""> 支/天</td>
                        <th align="right">血型：</th>
                        <td>
                            <select class="" name="blood_type">
                                <option value="1">A</option>
                                <option value="2">B</option>
                                <option value="3">AB</option>
                                <option value="4">O</option>
                            </select>
                        </td>
                    </tr>
                    <tr>
                        <th align="right" >过敏史：</th>
                        <td colspan="5"><input class="easyui-textbox" style="width:50%" name="allergy" value=""></td>
                    </tr>
                    </tbody>
                </table>
            </div>
        </div>
    </div>
</div>